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613-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Data Racelved 'Phone Contact for ParmtWn 9 <br /> ......................... <br /> owners Warne owner Phone Number <br /> Owners Addresall-NOD Owner Phone Number <br /> Fee Simple Tifleholder Name- Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS LOT# <br /> SUBDIVISION MyffacM I PARCEL 1061'0 W5—d U 0 _(M0_0011C()_() <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED NEWCONSTRR. ADDIALT SIGN- DEMOLISH <br /> - R INSTALL REPAIR <br /> PROPO91513'USE Q SPR COMM OTHER I <br /> TYPE OF CONSTRbCI1014 BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK IMO(Ahn 'n,'4n1j <br /> BUILDING SIZE SQ FOOTAGE=. HEIGHT'[= <br /> i"WiRW W44"M444 i W W i N H til.� <br /> =BUILDING VALUATION OF TOTAL CONSTikOCTION <br /> =ELECTRICAL AMP SERVICE Q PROGRESS ENERGY 0 W.R.E.C. <br /> ftpPLUMBING kwa.00 1, <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING SPECIALTY= OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA ='YES NO <br /> BUILDER COMPANY r <br /> SIGNATURE REGISTERED I YIN FEE CURREN L_XLN_j <br /> Address License#F— <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREN' L_YjNj, <br /> Address Ucense#r <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I YIN : FEECURREN <br /> Addroas License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I YIN FEECURM <br /> Addreou ucense# F <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED j'Y/ N-_ FEE CURREN <br /> Address License 0 <br /> RESIDENTIAL Attach(2).Plot.Plans;(2)iets'afBi ulkuhg Plans;(1)set of Energy Fo6s;R-C�W Permit for now Construction, <br /> Minimum ten(jQ)—fk(n9 days after submittal date,Required oniltd,Coholniction Plans;Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&I.dumpsteg-Alls Work-Pormit for subdIvIalonsfiarge pro]" <br /> COMMERCIAL Attach(3)complete-seti of BuIldIrig Plans plus a Ufa Safety Page;(1)set of Energy Forms,R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Planaw/Silt Fence Installed, <br /> Sanitary Facilities&I dumpster.Site Work Permit for all now projects.All Commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. -- - <br /> —PROPERTY SURVEY required for all NEW construction. <br /> Ali 11 11, 1 ON I I 1 91, 111 11 <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarised <br /> If ovow-02500.a Notice of Commoncament Is required. (AIC upgrades over$7500) <br /> Agent(for the contractor)or Power of Attorney(for ft*owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERrArMWG , (Front of Application Only) <br /> Remob If shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> DrIvoways-Not over Counter 119n Dublin madways..nieds ROW <br />